SUTURING AND REPAIRING TISSUE USING IN VIVO SUTURE LOADING

• US 20110270280A1
• Filed: 05/24/2011
• Published: 11/03/2011
• Est. Priority Date: 07/03/2007
• Status: Active Grant

• Current Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Original Assignee: Ceterix Orthopaedics, Inc (Smith & Nephew PLC)
• Inventors: Saliman, Justin D.
• Granted Patent: US 8,702,731 B2
• Time in Patent Office: Days
• US Class Current: 606/145
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0459 Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0461 with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/06047 located at the middle of the needle
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/0609 having sharp tips at both ends, e.g. shuttle needle alternately retained and released by first and second facing jaws of a suturing instrument MIS suturing instruments A61B17/0469; jaws of MIS forceps A61B2017/2926
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/2926 : Details of heads or jaws

Abstract

Described herein are methods of repairing tissue using a suture passer configured to relasably couple to a suturing element to pass the suturing element (and therefore a suture) through the tissue so that that the suture may be loaded and/or unloaded while the suture passer is positioned within the tissue. Thus, the methods described herein may allow the suture passer to be loaded without requiring that the suture passer be removed from within the patient or in some variations from off of the target tissue. The same suture or multiple sutures may thus be loaded and/or unloaded onto the suture passer, allowing the formation of complex suture patterns without requiring the extra steps of withdrawing the suture passer from the patient (or target tissue). Knotless suture anchors are also described.

Claims

1. A method of suturing a patient'"'"'s tissue using a suture passer and suturing element that is loaded with a suture while positioned within the patient, the method comprising:

positioning the suture passer within the patient, wherein the suture passer includes a tissue penetrator that is configured to engage a suturing element, pass the suturing element through the target tissue one or more times, and thereafter release the suturing element; and

coupling a suture to the suturing element while the suture passer and suturing element are within the patient.

2. The method of claim 1, wherein positioning the suture passer within the patient comprises positioning two jaws of the suture passer around the target tissue.

3. The method of claim 1, further comprising extending the tissue penetrator through the target tissue positioned between two jaws of the suture passer.

4. The method of claim 1, wherein positioning comprises percutaneously positioning the suture passer,

5. The method of claim 1, wherein coupling the suture to the suturing element comprises coupling the suture to a suture shuttle.

6. The method of claim 1, wherein coupling the suture to the suturing element comprises coupling the suture to a lead wire.

7. The method of claim 1, wherein coupling the suture to the suturing element comprises coupling the suture to a lead wire after passing the lead wire through the tissue.

8. A method of suturing tissue using a suture passer and suturing element that is loaded with a suture while positioned within the patient, the method comprising:

positioning the suture passer within the patient;

coupling a suture to a loadable end of the suture passer while the loadable end of the suture passer and the suture are within the tissue; and

passing the suture through a target tissue within the patient using the suture passer.

9. The method of claim 8, wherein the step of coupling comprises coupling the suture to a suture shuttle that is coupled to the loadable end of the suture passer.

10. The method of claim 8, wherein the step of coupling comprises passing a suture through an eyelet of a suture shuttle that is coupled to the loadable end of the suture passer.

11. The method of claim 8, wherein the step of coupling comprises using a hooked tool to pull the suture through an opening of a suture shuttle that is coupled to the loadable end of the suture passer,

12. The method of claim 8, further comprising anchoring the suture to the tissue before coupling the suture to the loadable end of the suture passer.

13. The method of claim 8, further comprising de-coupling the suture from the suture passer while the loadable end of the suture passer is within the tissue.

14. The method of claim 13, further comprising coupling the same or a different suture to the suture passer after de-coupling the suture.

15. The method of claim 8, wherein the step of positioning comprises positioning a continuous suture passer within the tissue.

16. The method of claim 8, wherein the suture passer comprises a continuous suture passer having a first and second jaw and a tissue penetrator configured so that the tissue penetrator is configured to extend from the first jaw, through the tissue and engage the second jaw, to alternately exchange a suture shuttle between the tissue penetrator and the second jaw.

17. The method of claim 8, wherein the coupling step comprises coupling the suture to a suture shuttle when the suture shuttle is releasably secured within the suture passer.

18. The method of claims 8, wherein the step of positioning the suture passer comprises percutaneously positioning the continuous suture passer.

19. The method of claim 8, wherein the step of coupling comprises coupling the suture a pull wire that is coupled to the loadable end of the suture passer.

20. The method of claim 19, wherein the pull wire is attached to a suture shuttle.

21. A method of suturing tissue using a suture passer and suturing element that is loaded with a suture while positioned within the patient, the method comprising:

positioning the suture passer within the tissue, wherein the suture passer is configured to pass a pull wire through the tissue;

passing the pull wire through the tissue using the suture passer;

coupling a suture to the pull wire while the suture and the pull wire are within the tissue; and

passing the suture through the tissue.

22. The method of claim 21, wherein the suture is anchored within the tissue prior to the coupling step,

23. The method of claim 21, further comprising removing the pull wire from the patient after passing the suture.

24. The method of claim 21, further comprising removing the suture passer from the patient before coupling the suture to the pull wire.

25. The method of claim 21, wherein passing the pull wire through the tissue comprises passing the pull wire from a first jaw of the suture passer to a second jaw of the suture passer.

26. The method of claim 21, wherein the step of positioning the suture passer comprises percutaneously positioning the continuous suture passer.